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Abstract:

The present invention provides an intracorporeal indwelling equipment
having an internal holding member to be set in the stomach. Said internal
holding member is composed of flexible ribbon-shaped members and flexible
membrane-like members that are set on the portions of ribbon-shaped
member, forming a dome-shaped portion. In the center of the outer
periphery of membrane-like member, a notch and folding creases are formed
to assist in deployment and help prevent the generation of ulcers and
buried bumper syndrome.

Claims:

1. Apparatus for intracorporeal indwelling, in which the intracorporeal
indwelling equipment has a cylindrical member to be set in the fistula
formed between the skin side wall portion on the body of the patient and
the wall portion of the prescribed portion in the body of the patient,
and an internal holding member that is connected to the tip of said
cylindrical member and is set on the inner side of said prescribed
portion, and it is for the fluid flow between the exterior of said
patient and the interior of said prescribed portion;said internal holding
member being composed of multiple flexible ribbon-shaped members, each
bending from the opening edge at the tip of said cylindrical member
towards the outer side and bonded to each other at their tips, and
flexible membrane-like members set on the portions of said multiple
ribbon-shaped members on said cylindrical member side and forming a
dome-like portion together with said multiple ribbon-shaped members; and
wherein a notch is formed on the outer periphery of the membrane-like
members of said dome-like portion; when said multiple ribbon-shaped
members are stretched so that the tip bonding portions of said
ribbon-shaped members separate from said cylindrical member, said
membrane-like members are folded, with said notch taken as the base of
the crease.

2. Apparatus claimed in claim 1 wherein each of said membrane-like members
forms a short, thin, linear portion extending from said notch to the side
of said cylindrical member.

3. Apparatus claimed in claim 1 wherein said ribbon-shaped members are
four ribbon-shaped members extending from the opening edge of said
cylindrical member towards the four sides with prescribed spacing between
them around the circumference; on each of the membrane-like members
formed between said four ribbon-shaped members, a said notch at the
center of the outer periphery of each said membrane-like member and a
short, thin, linear portion extending from said notch towards said
cylindrical member are formed.

4. Apparatus claimed in claim 3 wherein the shape of each said
membrane-like member is such that said short, thin, linear portion is
formed on the trough side, and the line connecting the portion of said
short, thin, linear portion on said notch side and the portion of the
outer periphery of each said membrane-like member on said membrane-like
member side is on the crest side.

5. Apparatus claimed in claim 1 wherein on said membrane-like members,
multiple long, thin, linear portions extending from the portions of the
outer periphery of said membrane-like members, except for said notches
towards said cylindrical member side, are formed with a prescribed
spacing between them.

6. Apparatus claimed in claim 5 wherein said ribbon-shaped members are two
ribbon-shaped members extending from the portions facing each other on
the opening edge of said cylindrical member in the opposite direction,
and each membrane-like member formed between said two ribbon-shaped
members has a said notch formed at the center of the outer periphery of
each said membrane-like member, a short, thin, linear portion extending
from said notch towards said cylindrical member side, and a long, thin,
linear portion extending from the portion between said ribbon-shaped
members towards said cylindrical member side.

7. Apparatus claimed in claim 6 wherein the shape of each said
membrane-like member is such that said short, thin, linear portion
becomes the trough portion, and the portion of said long, thin, linear
portion on the cylindrical member side forms the crest side, the portion
of each said membrane-like member on the outer periphery side becomes the
crest side, and, at the same time, the lines connecting the boundary
portion between the crest side portion and the trough side portion of
said long, thin, linear portion and the portions of the outer periphery
of each said membrane-like member on said notch side and on said
ribbon-shaped member side are formed on the crest side.

8. Intracorporeal indwelling equipment comprising a tube member for
insertion into a patient and an interior fixing member attached to a
distal end of the tube member at a connection region, the interior fixing
member comprising a plurality of resilient support members connecting a
coupling member to said connection region characterized in that said
interior fixing member further comprises a plurality of foldable
membrane-like members attached to and between said support members.

9. The intracorporeal indwelling equipment according to claim 8 wherein
said membrane-like members are arranged between upper portions of said
support members.

10. The intracorporeal indwelling equipment according to claim 8 wherein
said support members together with said membrane-like members form a dome
arrangement for contacting with an organ wall of a patient's organ.

11. The intracorporeal indwelling equipment according to claim 8 wherein
said membrane-like members include pre-formed creases in pre-determined
positions for controlling an unfolding and folding action of said
membrane-like members when a force is applied or removed from said
coupling member.

12. The intracorporeal indwelling equipment according to claim 8 wherein
said interior fixing member comprises two support members and two
membrane-like members.

13. The intracorporeal indwelling equipment according to claim 8 wherein
said interior fixing member comprises four support members and four
membrane-like members.

14. The intracorporeal indwelling equipment according to claim 13 wherein
two of said support members are relatively thin in relation to the other
two support members.

15. The intracorporeal indwelling equipment according to claim 8 wherein
said membrane-like members include a notch region in a medial region of a
free edge of said membrane-like member.

16. The intracorporeal indwelling equipment according to claim 15 wherein
each membrane-like member further includes at least one ridge region
extending from said connection region to a peripheral edge of said
membrane-like member.

17. The intracorporeal indwelling equipment according to claim 15 wherein
a crease region extends from an apex of said notch region to said
connection region.

18. The intracorporeal indwelling equipment according to claim 8 wherein
said equipment is a gastrostomy tube for insertion into a patient's
stomach.

19. A method of inserting an intracorporeal indwelling equipment into a
patient comprising the steps of:(i) providing an equipment according to
claim 1;(ii) placing an internal holding member of the equipment in an
insertion state in which membrane-like members of the holding member are
in a folded state and ribbon-like members of the holding member are in a
stretched state;(iii) introducing the equipment into the patient; and(iv)
placing the internal holding member in a deployed state in which the
membrane like members are unfolded and the ribbon-like members are in a
substantially relaxed state.

20. A method of inserting an intracorporeal indwelling equipment into a
patient comprising the steps of:(i) providing an equipment according to
claim 8;(ii) placing an internal fixing member of the equipment in an
insertion state in which membrane-like members of the holding member are
in a folded state and support members of the fixing member are in a
stretched state;(iii) introducing the equipment into the patient; and(iv)
placing the internal fixing member in a deployed state in which the
membrane like members are unfolded and the support members are in a
substantially relaxed state.

21. An intracorporeal indwelling equipment comprising an extension tube
and an internal holding member attached to a peripheral end of said
extension tube by a connection region, wherein said internal holding
member comprises a coupling member and a plurality of support members
connecting said coupling member to said connection region and a plurality
of skirt members extending between said support members and wherein each
said skirt member includes a notch region at a peripheral edge thereof
and wherein a fold region extends from an apex of said notch region
towards said connection region.

22. The intracorporeal indwelling equipment according to claim 21 wherein
each said skirt member includes at least one ridge region extending from
the peripheral edge of said skirt member towards the connection region,
the ridge region being arranged between the fold region and a respective
support member.

23. The intracorporeal indwelling equipment according to claim 21 wherein
said support members are elastically resilient.

24. The intracorporeal indwelling equipment according to claim 21 wherein
said skirt members each comprise an elastic membrane.

25. The intracorporeal indwelling equipment according to claim 21 wherein
said internal holding member comprises two support members.

26.-28. (canceled)

Description:

FIELD OF THE INVENTION

[0001]The present invention pertains to a type of intracorporeal
indwelling equipment for feeding fluid, such as liquid food or the like,
into the stomach or another prescribed portion of a patient, or for
exhausting urine or other fluid waste from renal pelvis or another
prescribed portion of the body of a patient.

BACKGROUND OF THE INVENTION

[0002]In the prior art, for a person who cannot take food by mouth on
his/her own due to age or disease (hereinafter to be referred to as the
patient), intracorporeal indwelling equipment is used to feed liquid
food, nutrients or other fluids. The intracorporeal indwelling equipment
is composed of the following parts: a cylindrical member inserted into
the fistula set in the body of the patient for taking the liquid food, an
internal holding member attached on the tip of the cylindrical member and
inserted into the stomach wall of the patient, and an external holding
member attached on the outer peripheral surface of the cylindrical member
and set on the skin surface side of the body of the patient (for example,
see Japanese Kokai Patent Application No. Hei 4[1992]-303461). For the
intracorporeal indwelling equipment, the internal holding member is made
of a triangular flange-like member set on the outer peripheral surface of
a cylindrical member. See also Applicant's earlier W02005/105018 (not
published at the priority date declared herein).

[0003]For said conventional intracorporeal indwelling equipment, because
of degradation that takes place for a prescribed period as well as change
in the thickness of the stomach wall corresponding to increase in the
body weight and growth of the patient, the indwelling equipment should be
replaced after each prescribed period. However, for the aforementioned
conventional intracorporeal indwelling equipment, because the internal
holding member spreads in the direction perpendicular to the cylindrical
member, it is difficult to perform the operation of insertion
into/withdrawing from the fistula of the patient. Also, because the
internal holding member is formed in a flat, flange-like shape, the
corners of the internal holding member stimulate the stomach wall, which
may generate ulcers. This is undesirable. It may also generate buried
bumper syndrome. Here, the buried bumper syndrome refers to the state in
which the holding force between the internal holding member and the
external holding member becomes higher, the tissues of the stomach wall
and abdominal wall become weaker, and the internal holding member is
gradually buried in the stomach wall and abdominal wall.

[0004]An objective of the present invention is to solve the aforementioned
problems of the prior art by providing a type of intracorporeal
indwelling equipment characterized by the fact that it facilitates
insertion into/withdrawing from the fistula of the patient, and that it
can prevent generation of ulcers or buried bumper syndrome.

SUMMARY OF THE INVENTION

[0005]In an embodiment, the present invention provides a type of
intracorporeal indwelling equipment comprising a cylindrical member set
in the fistula formed between the skin side wall portion on the body of
the patient and the wall portion of the prescribed portion in the body of
the patient, and an internal holding member that is connected to the tip
of said cylindrical member and is set on the inner side of said
prescribed portion, to permit fluid flow between the exterior of said
patient and the interior of said prescribed portion; said internal
holding member is composed of multiple flexible ribbon-shaped members,
each bending from the opening edge at the tip of said cylindrical member
towards the outer side and bonded to each other at their tips, and
flexible membrane-like members set on the portions of said multiple
ribbon-shaped members on said cylindrical member side, and forming a
dome-like portion together with said multiple ribbon-shaped members; a
notch is formed on the outer periphery of each membrane-like member of
said dome-like portion; when said multiple ribbon-shaped members are
stretched so that the tip-bonding portions of said ribbon-shaped members
separate from said cylindrical member, said membrane-like members are
folded with said notch taken as the base of the crease.

BRIEF DESCRIPTION OF DRAWINGS

[0006]For a better understanding of the present invention, and to show
more clearly how the same may be carried into effect, reference will now
be made, by way of example, to the accompanying drawings, in which:

[0007]FIG. 1 is a cross-sectional view illustrating the intracorporeal
indwelling equipment in the first embodiment of the present invention.

[0008]FIG. 2 is a plan view of the internal holding member in the
intracorporeal indwelling equipment shown in FIG. 1.

[0009]FIG. 3 is a front view of the internal holding member shown in FIG.
2.

[0010]FIG. 4 is a side view of the internal holding member shown in FIG.
2.

[0011]FIG. 5 is a front view illustrating the state in which the
intracorporeal indwelling equipment is stretched by the stretching unit.

[0012]FIG. 6 is a front view illustrating the extender.

[0013]FIG. 7 is a comparative example of the extender.

[0014]FIG. 8 is a plan view of the stretching auxiliary unit.

[0015]FIG. 9 is a front view of the stretching auxiliary unit.

[0016]FIG. 10 is a side view of the stretching auxiliary unit.

[0017]FIG. 11 is a plan view illustrating the stretched state of the
internal holding member.

[0018]FIG. 12 is a cross-sectional view illustrating the intracorporeal
indwelling equipment in the second embodiment of the present invention.

[0019]FIG. 13 is a plan view of the internal holding member in the
intracorporeal indwelling equipment shown in FIG. 12.

[0020]FIG. 14 is a front view of the internal holding member shown in FIG.
13.

[0021]FIG. 15 is a side view of the internal holding member shown in FIG.
13.

[0022]FIG. 16 is a front view illustrating the state in which the
intracorporeal indwelling equipment is stretched by a stretching unit
shown in FIG. 12.

[0023]FIG. 17 is a plan view of the internal holding member in the
intracorporeal indwelling equipment in the third embodiment of the
present invention.

[0024]FIG. 18 is a plan view illustrating the state in which the internal
holding member shown in FIG. 17 is stretched.

DETAILED DESCRIPTION OF THE INVENTION

First Embodiment

[0025]In the following, an explanation will be given regarding first
embodiment of the present invention. FIG. 1 shows intracorporeal
indwelling equipment A of this embodiment. This intracorporeal indwelling
equipment A is set in the fistula formed between the abdomen and stomach
wall of the patient for feeding fluids, such as liquid food or the like,
into the stomach. It is composed of external holding member (10),
cylindrical member (11) connected to the lower end of external holding
member (10), and internal holding member (20) attached on the lower end
of cylindrical member (11), all made of polyurethane. In the following,
an explanation will be given regarding the case when external holding
member (10) is on the upper side and internal holding member (20) is on
the lower side.

[0026]Said external holding member (10) is composed of main body (12)
formed in a rather thick ring shape, a pair of external holding pieces
(13a), (13b) protruding outward from the lower end portions of the
left/right sides of main body (12), lid member (14) integrally connected
to one external holding piece (13a), and cylindrical connecting portion
(15) formed at the center of the lower surface of main body (12). On the
peripheral surface of coupling hole (16) formed through in the vertical
direction at the center of main body (12), coupling crease (16a) is
formed along the circumference.

[0027]Said coupling hole (16) has a shape that is wider on the upper
opening side and tapers as the position of the lower portion of coupling
crease (16a) goes downward. On the lower end portion of coupling hole
(16), check valve (16b) is formed with a circular upper end opening and
linear lower end inflow port. A space is formed on the outer peripheral
side of said check valve (16b). Also, external holding pieces (13a),
(13b) extend horizontally from the side of main body (12), and, together
with main body (12), they work to prevent intracorporeal indwelling
equipment A from being sucked into the stomach.

[0028]Said lid member (14) is composed of ribbon-shaped connecting portion
(17) connected to external holding piece (13a) and stopper portion (18)
set on the tip side portion of ribbon-shaped connecting portion (17).
Said ribbon-shaped connecting portion (17) is flexible, and it can be
bent to rotate vertically or bent at a large angle around the connecting
portion with external holding piece (13a) at the center. Said stopper
portion (18) is set at a position facing coupling hole (16) when
ribbon-shaped connecting portion (17) is bent to have its tip side
portion positioned above main body (12). Said stopper portion (18) is
formed in a short cylindrical shape with a length that allows coupling to
coupling hole (16), and, on its outer peripheral surface, protrusions
(18a) are formed along the circumference that can engage with crease
(16a) on coupling hole (16) in a quick-connect/disconnect manner.

[0029]Consequently, when ribbon-shaped connecting portion (17) is bent and
stopper portion (18) is pressed in coupling hole (16), it is possible to
engage crease (16a) and protrusions (18a). As a result, coupling hole
(16) of main body (12) can be closed. Also, when the tip of ribbon-shaped
connecting portion (17) is pulled to release the coupling between stopper
portion (18) and coupling hole (16), coupling hole (16) of main body (12)
can be opened. Said connecting portion (15) extends downward from the
periphery of the space on the outer periphery of check valve (16b), and
the upper end portion of cylindrical member (11) is inserted into it and
fixed. At the center of said cylindrical member (11), feed flow path
(11a) is formed so that the liquid food or other fluids (not shown in the
figure) can pass through it, and the upper end of feed flow path (11a) is
connected via check valve (16b) to coupling hole (16) of external holding
member (10).

[0030]Said internal holding member (20) has the structure shown in FIGS.
2-4, and it is composed of cylindrical connecting portion (21), two
ribbon-shaped members (22a), (22b), membrane-like members (23a), (23b),
and coupling member (24). Said connecting portion (21) forms the upper
end portion of internal holding member (20), and it is fixed while the
lower end portion of cylindrical member (11) is inserted into it. Said
ribbon-shaped members (22a), (22b) are connected to the two side portions
on the lower end peripheral surface of connecting portion (21). After
extending outward from the facing portions on the outer peripheral
surface of connecting portion (21), they are bent to form a curve
extending from the lower side to the lower side of cylindrical member
(11).

[0031]That is, the lower end portions of ribbon-shaped members (22a),
(22b) are collected and fixed on the lower portion of the central axis of
cylindrical member (11). As shown in FIGS. 1 and 3, ribbon-shaped members
(22a), (22b) are formed facing each other to depict an ellipse with its
minor axis in the longitudinal direction. Also, said ribbon-shaped
members (22a), (22b) are flexible. Usually, by means of the elasticity,
an overall elliptical shape is maintained. However, as the lower end
portion is pulled downward, it stretches to a nearly linear shape. Then,
when the withdrawing force is removed, it recovers the original
elliptical shape.

[0032]Said membrane-like members (23a), (23b) are formed facing each other
in the upper side portion in between ribbon-shaped members (22a), (22b),
and they form together with the upper side portion of ribbon-shaped
members (22a), (22b) the contact portion (25) in dome shape having a
nearly elliptical plan view. The portion in contact with the stomach wall
of said contact portion (25) formed in a dome shape is formed in a nearly
planar shape. Also, said membrane-like members (23a), (23b) are flexible
thin membranes, and they stretch under the external force.

[0033]Consequently, when ribbon-shaped members (22a), (22b) deform under
external forces, membrane-like members (23a), (23b) follow the
deformation of ribbon-shaped members (22a), (22b) and also deform. Also,
notches (26a), (26b) are formed at the central portion of the outer
periphery (25a) (lower end edge) of membrane-like members (23a), (23b).
Said notches (26a), (26b) are formed in a nearly triangular shape with a
larger width at the lower side and tapering narrower as the position goes
upward. The edges on the two sides forming the triangular shape are
formed in an arc shape and protrude from the central side portion so that
notches (26a), (26b) become narrower.

[0034]Then, creases (27a), (27b) for folding are formed as short, thin,
linear portions of the present invention extending from the upper end
portions of notches (26a), (26b) to the lower end portion of connecting
portion (21). Also, creases (28a), (28b), (28c), (28d) for folding are
formed as the long, thin, linear portions of the present invention from
the outer periphery (25a) of membrane-like members (23a), (23b) to the
lower end of connecting portion (21) nearly to the central portion of
notches (26a), (26b) on outer periphery (25a) of membrane-like members
(23a), (23b) and their adjacent ribbon-shaped members (22a), (22b), and
the lower end portion of the corresponding connecting portion (21). Said
crease (28a), etc., for folding is formed along the dome shape of
membrane-like member (23a), etc., so that they are bent in the upper and
lower portion sides.

[0035]That is, for the shape of membrane-like members (23a), (23b),
creases (27a), (27b) for folding are on the trough side, and, for creases
(28a), (28b), (28c), (28d) for folding, the upper side portion is on the
crest side, and the lower side portion is on the trough side. Also, the
portions of lines (a) that connect the boundary portions between the
crest side portion and trough side portion in said creases (28a), (28b),
(28c), (28d) for folding and the portions of outer periphery (25a) of
membrane-like members (23a), (23b) on the side of notches (26a), (26b)
and on the side of ribbon-shaped members (22a), (22b) become the crest
side in the structure formed.

[0036]Consequently, when a prescribed force is applied on membrane-like
members (23a), (23b), membrane-like members (23a), (23b) are folded along
the direction that connects notches (26a), (26b) and creases (27a), (27b)
and along creases (28a), (28b), (28c), (28d). Said creases (27a), etc.,
have a structure with thin linear portions formed in the prescribed
portions of membrane-like member (23a), etc.

[0037]Also, coupling member (24) is formed in a short cylindrical shape in
the axial direction. By means of inserting plastic molding, it is fixed
on the lower end portion of ribbon-shaped members (22a), (22b). That is,
for coupling member (24), by connecting the lower end portions of
ribbon-shaped members (22a), (22b) on the side lower end portion,
ribbon-shaped members (22a), (22b) are connected to each other and, at
the same time, its position is located below the central axis of
cylindrical member (11) by ribbon-shaped members (22a), (22b). Also, in
the central portion on the upper end of coupling member (24), hole (24a)
is formed for positioning the tip of extender (31) (see FIG. 5). The
inner periphery of said hole (24a) has a slope formed on it with the
upper side having a larger diameter. It is positioned such that the tip
of extender (31) is in contact with the slope surface.

[0038]As shown in FIG. 5, when intracorporeal indwelling equipment A with
said constitution is used, intracorporeal indwelling equipment A
stretches by means of extending unit (30). Said extending unit (30) is
composed of extender (31) shown in FIGS. 6 and 7 and cylindrical portion
(32) shown in FIGS. 8-10. Said extender (31) has cylindrical main body
(33) with internal cavity (33a) made of a stainless steel cylindrical
body and formed for passing a guide wire (not shown in the figure)
through it, and grip (34) made of plastic material. Then, on the lower
end of cylindrical main body (33), a chip (35) made of plastic material
is attached.

[0039]Said grip (34) is formed as a hand-hold extender (31), and it is
composed of coupling portion (34a) fixed on cylindrical main body (33)
while the upper outer periphery of cylindrical main body (33) is covered,
and holding portion (34b) is integrally formed to coupling portion (34a).
On the outer peripheral surface of coupling portion (34a), five step
portions (34c) are formed with a prescribed vertical spacing. Said step
portions (34c) are formed by ring-shaped protrusions with a semicircular
cross-sectional shape set along the circumference of coupling portion
(34a).

[0040]As shown in FIGS. 6 and 7, said holding portion (34b) is formed in a
nearly triangular shape with the width in the left/right direction
tapered larger as the position moves up. In its interior, inserting hole
(34d) that connects to lumen (33a) of cylindrical main body (33) is
formed in the vertical direction. Said inserting hole (34d) is formed in
nearly triangular shape with the upper side portion of one side portion
(the left side portion in FIG. 7) from the central portion in the
left/right direction of holding portion (34b) becoming wider. On the
upper surface of holding portion (34b), a curved surface with arc-shaped
recess is formed to facilitate fitting of the hand and fingers during
operation of extender (31).

[0041]Chip (35) is composed of fixing portion (35a) fixed on cylindrical
main body (33) while the peripheral surface of the lower end portion of
cylindrical main body (33) is covered, and press-in piece (35b) extends
from the lower end of fixing portion (35a) downward. The outer diameter
of fixing portion (35a) is selected to be larger than the diameter of
hole (24a) of coupling member (24), and the diameter of press-in piece
(35b) is selected to be smaller than the diameter of hole (24a).
Consequently, when extender (31) is inserted downward from coupling hole
(16) of intracorporeal indwelling equipment A, press-in piece (35b)
enters the hole (24a) of coupling member (24), and, for fixing portion
(35a), the lower surface becomes positioned on the upper surface of
coupling member (24). Consequently, when extender (31) is pressed
downward into intracorporeal indwelling equipment A, as shown in FIG. 5,
internal holding member (20) becomes slender and extends.

[0042]Extending auxiliary member (32) is formed by processing a stainless
steel sheet. It is composed of lower coupling portion (36), upper
coupling portion (37) and connecting piece (38) in rectangular shape
extending vertically and connecting lower coupling portion (36) with
upper coupling portion (37). Said lower coupling portion (36) is composed
of holding piece (36a) having a nearly U-shape in the plan view and
formed perpendicular to connecting piece (38) and extending horizontally
towards the front side as shown in FIG. 9, and a pair of hooks (36b) that
are perpendicular to connecting piece (38) and holding piece (36a) and
are set parallel to each other with a prescribed spacing from holding
piece (36a). Also, the nearly U-shaped inner portion of holding piece
(36a) is formed in the recess with a size appropriate for inserting of
connecting portion (15) of external holding member (10), and the spacing
between holding piece (36a) and hooks (36b) is selected to be size an
appropriate for holding external holding pieces (13a), (13b).

[0043]Said upper coupling portion (37) is formed as a lateral plate member
extending from the upper end portion of connecting piece (38),
perpendicular to connecting piece (38) and towards the front-side
horizontal direction shown in FIG. 9, and extending to the directions of
both sides of connecting piece (38). Also, the length in the longitudinal
direction of upper coupling portion (37) is selected to be short, and
coupling recess (37a) that can be coupled to each step portion (34e) of
extender (31) is formed in the central front portion. Also, on the two
side portions of coupling recess (37a) in the front portion of upper
coupling portion (37), a pair of downward protrusions (37b) is formed for
preventing the release of the coupling with step portions (34c).

[0044]The two side portions in the left/right direction of upper coupling
portion (37) are bent downward so as to facilitate hand-held operation,
and the tip of holding piece (36a) is bent upward for preventing release
of the coupling with external holding pieces (13a), (13b). In addition,
the upper side portion of connecting piece (38) is bent so that it is
inclined relative to the lower side portion for aligning the positions in
the vertical direction of the center of the recess of holding piece (36a)
and the center of coupling recess (37a).

[0045]For extending unit (30) with said constitution, when intracorporeal
indwelling equipment A is stretched, first, extender (31) is inserted
from coupling hole (16) of external holding member (10) to the lower side
of cylindrical member (11), and press-in piece (35b) is inserted into
hole (24a) while aligned to coupling member (24) of internal holding
member (20). Then, while external holding pieces (13a), (13b) of
intracorporeal indwelling equipment A in this state are inserted between
holding piece (36a) and hook (36b), extending auxiliary member (32) is
assembled with intracorporeal indwelling equipment A and extender (31)
while connecting portion (15) is positioned in the recess of holding
piece (36a).

[0046]Then, the upper surface of holding portion (34b) is pressed by a
hand, and a finger engages with the lower surface of upper coupling
portion (37) while extending auxiliary member (32) is pulled upward
without press-in piece (35b) being removed from hole (24a), and the edge
of coupling recess (37a) is coupled to a prescribed step portion (34c),
such as step portion (34c) positioned as the second from the lower side.
Consequently, as shown in FIG. 5, internal holding member (20) stretches
and becomes slender, and cylindrical member (11) and internal holding
member (20) become rod-like. In this case, internal holding member (20)
is folded so that recesses are formed with creases (27a), (27b) for
folding of membrane-like members (23a), (23b) as the boundary, so that
the creases (28a), (28b), (28c), (28d) for folding on the side of
connecting portion (21) become the crest side (protrusion side).

[0047]Also, creases (28a), (28b), (28c), (28d) for folding are folded so
that the portions on the side of outer periphery (25a) become the crest
side. In this case, as shown in FIG. 2, folding is performed so that the
portions indicated by lines (a) become the boundary lines. In this way,
internal holding member (20) becomes a fine rod shape, and its plan view
becomes small in size as shown in FIG. 11. In this case, not only
internal holding member (20), but also cylindrical member (11), is
stretched. Also, for external holding pieces (13a), (13b), the bent
portion at the tip of holding piece (36a) prevents them from getting out
from holding piece (36a). For step portions (34c) of extender (31),
intracorporeal indwelling equipment A and extending unit (30) are
assembled while protrusions (37b) act to prevent them from getting out of
coupling recess (37a).

[0048]Then, in this state, intracorporeal indwelling equipment A passes
through the fistula (not shown in the figure) formed between the
abdominal wall and the stomach wall of the patient. Then, as internal
holding member (20) enters the stomach of the patient, while the finger
is on the lower surface of upper coupling portion (37), extending
auxiliary member (32) is pulled up, and, while coupling recess (37a) is
removed from step portion (34c), holding piece (36a) and hooks (36b) are
removed from external holding pieces (13a), (13b), and extending
auxiliary member (32) is removed from intracorporeal indwelling equipment
A. In addition, extender (31) is withdrawn from intracorporeal indwelling
equipment A. Then, ribbon-shaped connecting portion (17) is folded and
stopper portion (18) is pressed onto the coupling hole (16) of main body
(12) to close the coupling hole (16).

[0049]As a result, the shape of internal holding member (20) returns to
the original state shown in FIG. 1 due to the elasticity, and the upper
surface of contact portion (25) comes into contact with the inner surface
of the stomach wall. Cylindrical member (11) also returns to the original
state. As a result, it is possible to prevent intracorporeal indwelling
equipment A from withdrawing from the fistula, and it is kept attached in
the abdominal portion of the patient. Also, the portions of the abdominal
wall and the stomach wall near the fistula are fixed by intracorporeal
indwelling equipment A, and their respective positions do not shift. In
this case, the following scheme is preferred: a certain gap is formed
between the surface of the abdominal wall and the lower surface of
external holding member (10), and a certain freedom is realized between
intracorporeal indwelling equipment A and the fistula.

[0050]When liquid food, nutrients, or other fluids are to be fed to the
patient coupling hole (16) of external holding member (10) is opened, and
a tube (not shown in the figure) for feeding the fluid is connected to
coupling hole (16). In this state, the fluid enters from the end opening
of the fluid feeding tube into the fluid feeding tube. As a result, the
fluid substance is fed from the fluid feeding tube via coupling hole (16)
and the feeding flow path (11a) into the stomach of the patient. In this
case, the fluid flows out from the lower end opening of cylindrical
member (11) and from the interior of internal holding member (20) through
the portion between ribbon-shaped members (22a), (22b) and into the
stomach. After use, the fluid feeding tube is removed from external
holding member (10), and coupling hole (16) is closed.

[0051]Also, when it is necessary to make an exchange due to changes in the
properties, such as stretching, of intracorporeal indwelling equipment A,
etc., after use for a prescribed period of time, extender (31) and
extending auxiliary member (32) are attached by means of said process to
intracorporeal indwelling equipment A while it is kept in the abdomen of
the patient. In this case, if stretching of intracorporeal indwelling
equipment A occurs, coupling recess (37a) of extending auxiliary member
(32) is coupled to step portion (34c) of the third or larger numbered one
counted from the lower side. As a result, it is possible to have internal
holding member (20) in a fine size appropriate for withdrawals. In this
way, while internal holding member (20) is in the slender state,
intracorporeal indwelling equipment A can be withdrawn from the body of
the patient together with extender (31) and extending auxiliary member
(32). Then, new intracorporeal indwelling equipment A is attached to the
body of the patient using the aforementioned process.

[0052]When said intracorporeal indwelling equipment A is exchanged, a
guide wire is fed through lumen (33a) of extender (31), and, after the
used intracorporeal indwelling equipment A is removed from the fistula,
the guide wire is left within the abdominal and stomach walls. As a
result, while the positions of abdominal wall and stomach wall are kept
constant, the new intracorporeal indwelling equipment A can be attached
in the fistula. Also, in this case, since insertion hole (34d) for
extender (31) is tapered with its upper side wider, by positioning the
guide wire on the end side of insertion hole (34d), the guide wire does
not hamper the operation of extender (31).

[0053]In this way, in intracorporeal indwelling equipment A, internal
holding member (20) is composed of two flexible ribbon-shaped members
(22a), (22b) and membrane-like members (23a), (23b) formed across the
upper side between them. Consequently, when intracorporeal indwelling
equipment A is mounted on extending unit (30), as ribbon-shaped members
(22a), (22b) are stretched to a nearly linear shape, membrane-like
members (23a), (23b) collapse to a rod shape as they follow ribbon-shaped
members (22a), (22b). On membrane-like members (23a), (23b), notches
(26a), (26b) and creases (27a), (27b), (28a), (28b), (28c), (28d) are
formed. When internal holding member (20) extends, membrane-like members
(23a), (23b) are folded into a prescribed shape by means of notch (26a),
etc., and they become smaller as shown in FIG. 11.

[0054]For this purpose, it becomes easier to insert internal holding
member (20) and cylindrical member (11) into the fistula of the patient
or to withdraw them from the fistula of the patient. After intracorporeal
indwelling equipment A is inserted into the stomach, the portion of
internal holding member (20) on the side of cylindrical member (11)
returns to the dome-like shape, and dome-shaped contact portion (25)
comes into contact with the stomach wall. Consequently, irritation of the
stomach wall by internal holding member (20) or invasion of the stomach
wall by the member can be prevented, and it is possible to prevent ulcers
and buried bumper syndrome. In addition, because internal holding member
(20) is formed in a nearly elliptical shape in the plan view, when the
fistula is formed in a nearly elliptical shape, attachment of
intracorporeal indwelling equipment A in the fistula becomes easier.
Also, because intracorporeal indwelling equipment A can be inserted so
that it fits the shape of the fistula, it is possible to reduce
resistance during insertion.

Second Embodiment

[0055]FIG. 12 is a diagram illustrating intracorporeal indwelling
equipment B in a second embodiment of the present invention. FIGS. 13-15
illustrate internal holding member (40) of intracorporeal indwelling
equipment B. Said internal holding member (40) is composed of cylindrical
connecting portion (41), four ribbon-shaped members (42a), (42b), (42c),
(42d), four membrane-like members (43a), (43b), (43c), (43d), and
coupling member (44). Said connecting portion (41) has the same
constitution as that of connecting portion (21) of said intracorporeal
indwelling equipment A. Said ribbon-shaped members (42a), (42b), (42c),
(42d) are connected to the lower end outer peripheral surface of
connecting portion (41). They extend outward from the outer peripheral
surface of connecting portion (41) to the four sides and are then bent,
and they form a curved shape as they extend from the lower side towards
the right, below connecting portion (41).

[0056]That is, the lower end portions of ribbon-shaped members (42a),
etc., are gathered and fixed on the lower portion of the central axis of
connection portion (41). Ribbon-shaped members (42a), (42c) and
ribbon-shaped members (42b), (42d) are formed facing each other to depict
an ellipse with the minor axis in the longitudinal direction. Also,
membrane-like members (43a), (43b), (43c), (43d) are formed in the upper
side portions between the various portions adjacent to ribbon-shaped
members (42a), (42b), (42c), (42d), and, together with the upper side
portions of ribbon-shaped members (42a), etc., they form a nearly
dome-shaped contact portion (45).

[0057]Notches (46a), (46b), (46c), (46d) are formed at the central
portions of outer periphery (45a) of various membrane-like members (43a),
etc., respectively. Said notches (46a), etc., are formed in a nearly
triangular shape similar to that of notches (26a), etc., of
intracorporeal indwelling equipment A. As short, thin, linear portions of
the present invention, creases (47a), (47b), (47c), (47d) for folding are
formed from the upper end portion of notches (46a), etc., to the lower
end portion of connecting portion (41).

[0058]In this case, the shape of membrane-like members (43a), (43b),
(43c), (43d) is such that creases (47a), (47b), (47c), (47d) become the
trough side, and the portions of lines (b) that connect the portions of
creases (47a), etc., for folding on the side of notches (46a), (46b),
(46c), (46d) and the side portions of ribbon-shaped member (42a), etc.,
in outer periphery (45a) of membrane-like member (43a), etc., become the
crest side. Also, on said internal holding member (40), the creases for
folding that correspond to the long, thin, linear portions of the present
invention are not formed. The constitution of the portion other than
intracorporeal indwelling equipment B is the same as intracorporeal
indwelling equipment A. Consequently, the same part numbers are adopted
to represent the same parts.

[0059]Also, for intracorporeal indwelling equipment B, said extending unit
(30) is used and, as shown in FIG. 16, it is put into the fistula of the
patient while internal holding member (40) is in the stretched state. In
this case, internal holding member (40) is folded such that the lines
that connect notches (46a) of membrane-like member (43a), etc., and
creases (47a), etc., for folding are on the trough side. Also, in this
case, folding is performed for membrane-like member (43a), etc., such
that the portions indicated by lines (b) in FIG. 13 (the lines that
connect the crossing portions between outer periphery (45a) of
membrane-like member (43a), etc., and ribbon-shaped member (42a), etc.,
and the boundaries between those creases (47a), (47b), (47c), (47d) for
folding on the side of outer periphery (45a) and those creases (47a),
etc., on the side of connecting portion (41) become the boundary lines on
the crest side portion.

[0060]For the aforementioned constitution, when internal holding member
(40) is inserted into the stomach, said four membrane-like members (43a),
etc., expand to the four sides, and they are in contact with the stomach
wall in good balance. As a result, it is possible to prevent ulcers and
buried bumper syndrome. The other functions and effects of intracorporeal
indwelling equipment B are the same as those of input/output interface A.

Third Embodiment

[0061]FIG. 17 is a diagram illustrating the upper view of internal holding
member (50) having the intracorporeal indwelling equipment in a third
embodiment of the present invention. In this embodiment, the internal
holding member (50) is composed of narrow (fine) ribbon-shaped members
(52a), (52c) as the portions corresponding to ribbon-shaped members
(42a), (42c) on internal holding member (40) shown in FIG. 13. The other
features of the constitution of the intracorporeal indwelling equipment
having internal holding member (50) are the same as those of
intracorporeal indwelling equipment B. Consequently, the same part
numbers as the aforementioned are adopted, and they will not be explained
again. In this case, as internal holding member (50) stretches, the shape
in the plan view becomes that shown in FIG. 18. In this case, too,
insertion and withdrawal of the intracorporeal indwelling equipment can
be easily performed.

[0062]The present invention is not limited to the aforementioned
embodiments. The present invention may also be changed appropriately. For
example, in said embodiments, intracorporeal indwelling equipment A,
etc., is made of polyurethane. However, other materials may also be
adopted for forming intracorporeal indwelling equipment A, etc., such as
polypropylene, silicone, polycarbonate, and other resin materials. Also,
in the aforementioned embodiments, intracorporeal indwelling equipment A,
etc., have external holding member (10). However, external holding member
(10) may be absent from the intracorporeal indwelling equipment, and the
cylindrical member may also be made of a long tube.

[0063]In addition, for ribbon-shaped member (22a), etc., in intracorporeal
indwelling equipment A, etc., appropriate changes may be made in the
number, shape, etc., of creases (47a), etc., for folding, such as notch
(26a). In said embodiments, the stomach is taken as the organ in the body
for attachment of intracorporeal indwelling equipment A. However, the
organ is not limited to the stomach. For example, it may also be adopted
for the duodenum and the other intestines, renal pelvis, bladder, etc.
For example, it may be used to remove urine from the renal pelvis, or for
removing other contents from the body.

[0064]For the intracorporeal indwelling equipment of the present invention
with the aforementioned constitution, the internal holding member is
composed of multiple flexible ribbon-shaped members and membrane-like
members formed between them. Consequently, when the ribbon-shaped members
become similar to a straight line shape (hereinafter to be referred to as
a linear shape), the membrane-like members collapse after them into a rod
shape. Also, notches are formed on the outer periphery of the
membrane-like members, and, when the multiple ribbon-shaped members are
stretched into a linear shape, the membrane-like members are folded to a
prescribed shape with the notches as the base portions. That is, when the
ribbon-shaped members are stretched into linear shape, the membrane-like
members are folded with the lines that connect the cylindrical member
side portion with the notches as it creases. Also, in this case, the base
of the crease refers to the portion from which the crease is formed.

[0065]Consequently, when the internal holding member and the cylindrical
member are inserted into the fistula of the patient or pulled out from
the fistula, for example, when a rod-shaped extender or the like is
inserted into the cylindrical member, the bonding portion of the tip of
the ribbon-shaped member is pressed by the tip of the extender, so that
the internal holding member is folded and becomes a slender rod shape
that extends along the extender. Also, in this case, the membrane-like
members do not expand in an irregular shape. Instead, together with the
ribbon-shaped members, they become a slender rod shape in a prescribed
shape. As a result, the intracorporeal indwelling equipment can be
inserted into the fistula of the patient or pulled out from the fistula
easily.

[0066]Also, after the intracorporeal indwelling equipment has been
inserted into the prescribed portion, the extender is pulled from the
cylindrical member, the portion of the internal holding member on the
cylindrical member side recovers the dome shape, and the dome-shaped
portion comes into contact with the inner wall surface of the prescribed
portion. Consequently, the internal holding member does not irritate the
inner wall of the prescribed portion and does not invade the inner wall.
As a result, it is possible to prevent generation of ulcers or buried
bumper syndrome. Also, the "prescribed portion" in this case refers to
any of the organs in the human body, such as stomach, duodenum and other
intestines, renal pelvis, bladder, etc.

[0067]In this case, the notches may be (inter alia) any of the following
types: linear notches extending from the outer periphery of the
dome-shaped portion towards the cylindrical member side, notches with a
prescribed width on the opening side, notches each with the opening side
in contact and closed and with recess formed in a prescribed shape on the
inner side, etc. Among these notches, in particular, the notch formed
with the width tapered narrower from the outer periphery of the
dome-shaped portion towards the cylindrical member side is preferred. As
a result, in addition, the membrane-like members can be folded easily.
Also, the internal holding member and the cylindrical member can be
connected using a cylindrical connecting portion. The connecting portion
can be integrally formed to the internal holding member or integrated
with the cylindrical member. Also, when the internal holding member and
the cylindrical member are integrally formed, there is no need to have
the connecting portion.

[0068]As another feature of the intracorporeal indwelling equipment of the
present invention, each said membrane-like member forms a short, thin,
linear portion extending from said notch to the side of said cylindrical
member. As a result, by means of the notch and the short, thin, linear
portion, the folding direction of the membrane-like members becomes
constant. That is, by means of the notch, the starting point of the
crease is determined, and the crease extends along the short, thin,
linear portion. Consequently, the membrane-like members can deform
reliably so that they collapse to the ribbon-shaped member side extending
in the linear shape.

[0069]As another feature of the intracorporeal indwelling equipment of the
present invention, said ribbon-shaped members are four ribbon-shaped
members extending from the opening edge of said cylindrical member
towards the four sides with prescribed spacing between them around the
circumference; on each of the membrane-like members formed between said
four ribbon-shaped members, a notch at the center of the outer periphery
of said membrane-like member and a short, thin, linear portion extending
from said notch towards said cylindrical member are formed. In this case,
the following scheme is preferred: the shape of said membrane-like member
is such that said short, thin, linear portion is formed on the trough
side, and the line connecting the portion of said short, thin, linear
portion on said notch side and the portion of the outer periphery of said
membrane-like member on said membrane-like member side is on the crest
side.

[0070]In this way, as the internal holding member is inserted into the
prescribed portion, the four ribbon-shaped members extend to the four
sides, so that the intracorporeal indwelling equipment can be set in the
fistula with good balance. Also, when the intracorporeal indwelling
equipment is stretched, the internal holding member always becomes the
same slender shape, so that the intracorporeal indwelling equipment can
be inserted into the fistula of the patient or pulled out from the
fistula of the patient easily.

[0071]As yet another feature of the intracorporeal indwelling equipment of
the present invention, said membrane-like members, multiple long, thin,
linear portions extending from the portions of the outer periphery of
said membrane-like members, except for said notches, towards said
cylindrical member side are formed with a prescribed spacing between
them. As a result, when the ribbon-shaped members are stretched to a
linear shape, the membrane-like members are folded along the long, thin,
linear portions and they collapse to the ribbon-shaped member side, or
they are folded to the inner side of the ribbon-shaped members. As a
result, the membrane-like members collapse together with the
ribbon-shaped members into a rod shape with a certain regularity.

[0072]As yet another feature of the intracorporeal indwelling equipment of
the present invention, said ribbon-shaped member are two ribbon-shaped
members extending from the portions facing each other on the opening edge
of said cylindrical member in the opposite direction, and each
membrane-like members formed between said two ribbon-shaped members has a
notch formed at the center of the outer periphery of said membrane-like
member, a short, thin, linear portion extending from said notch towards
said cylindrical member side, and a long, thin, linear portion extending
from the portion between said ribbon-shaped members towards said
cylindrical member side.

[0073]In this case, the following scheme is preferred: the shape of said
membrane-like member is such that said short, thin, linear portion
becomes the trough portion, and the portion of said long, thin, linear
portion on the cylindrical member side forms the crest side, the portion
of said membrane-like member on the outer periphery side becomes the
crest side, and, at the same time, the lines connecting the boundary
portion between the crest side portion and the trough side portion of
said long, thin, linear portion and the portions of the outer periphery
of said membrane-like member on said notch side and on said ribbon-shaped
member side are formed on the crest side.

[0074]As a result, when the stomach fistula is formed in a non-circular
shape, such as an elliptic shape, attachment of the intracorporeal
indwelling equipment in the stomach fistula can be performed easily. That
is, by adjusting the orientation of the intracorporeal indwelling
equipment to fit the shape of the fistula, it is possible to reduce the
resistance when the intracorporeal indwelling equipment is inserted in
the fistula. Also, in this case, the shape of the membrane-like members
is the same as that when the multiple ribbon-shaped members are not
stretched. During the process when the ribbon-shaped members are
stretched, the crest side portion of the membrane-like member and the
trough side portion of the membrane-like member become different from
each other. When the ribbon-shaped members have been stretched, the crest
and trough sides become the same as those before stretching of the
ribbon-shaped members. As a result, when the intracorporeal indwelling
equipment is stretched, the internal holding member always keeps the same
slender shape. Consequently, insertion of the intracorporeal indwelling
equipment into the fistula of the patient and withdrawing of the
intracorporeal indwelling equipment from the fistula of the patient
become easier.

[0075]Other variations and modifications will be recognized by those of
ordinary skill in the art as being within the scope of the present
invention.